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Please complete the following application.

Employment Application Zavcor Trucking Limited 3650 Eagle ST. P.O. Box 180 Stevensville, ON L0S 1S0
Date of Application:		Position Applied For:
Name:	Last, First, Initial	Social Insurance Number:
Address:		City:
Province/ State:		Postal Code:
Phone:
E-mail:
Address for past three years if different than above:
Address 1:		How Long?:
Address 2:		How Long?:
Do you have the legal right to cross the border into the United States? Yes No
Do you now, or have you ever had a criminal charge? Yes No
Do you have a FAST card? Yes No
Date of Birth:	mm/dd/yy	Can you provide proof of age?	Yes No
Have you worked for this company before? Yes No Dates:
When would you be able to start?
Who referred you?
Expected rate of pay:

EMPLOYMENT HISTORY
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. Applicants to drive a commercial motor vehicle* in interstate or intrastate shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle. NOTE: List employers in reverse order starting with the most recent. Add another sheet as necessary. *Includes vehicles having GVWR of 26 001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport Hazardous Materials in quantity required placarding.
Employer		Date
Name:		From:	To:
Address:		Position Held:
City:		State/Postal Code:
Contact Person:		Salary/Wage:
Reason for Leaving:		Phone:
Employer		Date
Name:		From:	To:
Address:		Position Held:
City:		State/Postal Code:
Contact Person:		Salary/Wage:
Reason for Leaving:		Phone:
Employer		Date
Name:		From:	To:
Address:		Position Held:
City:		State/Postal Code:
Contact Person:		Salary/Wage:
Reason for Leaving:		Phone:
*Accident record for past 3 years or more*
Dates	Nature of Accident (Head on, Rear-End, Upset, etc.)	Fatalities	Injuries
Last Accident:
Next Previous:
Next Previous:
Next Previous:
Traffic Convictions and Forfeitures for the past 3 years (other than parking)
Location	Date	Charge	Penalty

Education

Select highest grade completed:
1 2 3 4 5 6 7 8
High School:
9 10 11 12
College:
1 2 3 4

Experience and Qualifications - Drivers
Drivers Licenses

Province/State

License Number

Type

Expiration Date

Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Yes No

Has any license, permit or privilege ever been suspended or revoked?
Yes No

If the answer is yes to the above, give details:

Class of Equipment

Type of Equipment (Van, Tank, Flat Etc.)

Dates
From:

To:

Approx. No of Miles
(Total)

Straight Truck

Tractor & Semi-Trailor

Tractor - Two Trailers

Other

List states operated in for last five years:

Show special courses or training that will help you as a driver:

Which safe driving awards do you hold and from whom?

In addition to meeting the minimum requirements set out in Part 391.41 of the Federal Motor Carriers Regulations, a successful candidate must be able to perform the following actions.
Please check the appropriate box beside each item.

1. Lifting - Packages ranging from 5-45 pounds.

Yes No Don't Know

2. Climbing - Into and out of tractor cabs, loading docks and trailers.

Yes No Don't Know

3. Pulling - Full strength horizontal to hook and unhook a trailer and open hood to do under hood checks.

Yes No Don't Know

4. Crouching - daily during pre- and post-trip inspections plus other.

Yes No Don't Know

5. Lying down - 8-10 hours.

Yes No Don't Know

6. Sitting - Up to 15 hours daily.

Yes No Don't Know

7. Reaching - With arms as well as feet - steering wheel, gear shift, accelerator, clutch and brakes.

Yes No Don't Know

8. English - Able to read, write and understand the English language.

Yes No Don't Know

In your opinion what makes a great trucking company successful?

Why do you think Zavcor Trucking should hire you?

Is the customer always right? Why?

Why would you like to work for Zavcor Trucking?
Describe what great trucking service means?
Are you willing to conform to our 100kph speed limit? Yes No
Why is it important for the drivers to have a neat, clean and professional appearance?
Most carriers can deliver goods between A & B in a timely manner. Zavcor Trucking strives to provide a premium trucking service, with an emphasis on customer satisfaction as well as public and employee safety. We believe, having a positive attitude, being co-operative and courteous even in unpleasant situations are factors that make up total customer satisfaction. Our ability to provide this will set us apart from our competitors and make us and our employees successful. How does your personality fit with Zavcor's philosophy to ensure we maintain the level of quality we have just described?
TO BE READ AND SIGNED BY APPLICANT
This certifies that this application was completed by me and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of Zavcor Trucking Limited. Date: Applicant's Name:
Thank you for your interest in Zavcor Trucking Limited Zavcor Truk-King Zavcor Trucking Limited is an ISO 9001 Registered Company.